A case report of an unconventional chronic lead poisoning resulting from daily eyelid application of kohl

一例因每日在眼睑上涂抹眼线膏而导致的非典型慢性铅中毒病例报告

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Abstract

INTRODUCTION: Lead can be found everywhere in the environment and continues to be a public health concern. Lead exposure through kohl is a well-identified problem. In adults, the few reported cases show that this exposure is underestimated. The health consequences of chronic exposure are not well known. CASE REPORT: a 63-year-old woman contacted the Department of Medical Pharmacology and Toxicology to report suffering from numerous neurological disorders. She mentioned having previously undergone toxicological assessments showing abnormally high levels of lead and mercury about three years ago. Several lead tests revealed active lead exposure but at levels considered subtoxic, 170-198 μg/L. Subsequently, several interviews with an internist and a toxicologist allowed the identification of the contamination source: kohl. After discontinuing the use of kohl, it took a year for lead concentrations to drop below 50 μg/L. Apart from neurological symptoms, neither renal function nor hematopoiesis was affected. DISCUSSION: This is the first case report describing the effects of chronic lead poisoning in adults over a period of more than 40 years. It is crucial to raise awareness among populations about daily using traditional kohls and to avoid these products due to their manufacturing process using galena.

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